Early Dementia Onset? What to do?

Ted

Ted

The pilot formerly known as Twin Engine Ted
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My mother is 70, been retired since her mid 30s and hasn't used her brain much since retiring. Lives alone, doesn't get out much but has two homes she travels between. My grandmother had dementia as she aged, although starting in her 80s.

She's been seeming to lose touch with reality now and then, but usually in harmless manners so I've brushed it off as personality. She's been visiting us, and today my wife said my mom insisted I was home and she'd just been talking to me. I've been at the office since before she woke up, so this is concerning. She wasn't napping, so it's not likely that it was just a dream she confused for reality.

I'm wondering if dementia is setting in for her, and at what point she should get evaluated, and at what point I should start to really get concerned. I live about 1,000 miles away so I'm not able to make regular trips to check on her. There are people back home who I could ask to keep an eye on her. My concern is making sure she doesn't end up either making some mistake that hurts her (physically or financial) or getting somehow lost, especially while traveling. Fortunately, she doesn't drive.
 
From my own experience - get it checked. It's the only way to know what's going on.

It could be early dementia, it could be the result of other things like a stroke or TIA.

Find out first what you are dealing with, it will make a difference on the direction you go after that.

edit: you can start getting the papers ready for power-of-attorney, in any case.
 
We've already gotten power of attorney and end of life plans figured out, so that's fortunate.

Next question: how does one arrange the evaluation and broach this topic? She will not be happy for me to bring it up. She also is on multiple meds for varying ailments, which could also be interfering.
 
Sorry to hear this, I'm dealing with a similar issue, although my mom is older. It's tough to watch the progression, especially now for me, as it is time to intervene. My mom is adamantly opposed to changing her life, she lives by herself, the doctor had told me to get a guardianship. As far as how to test and manage it, there are doctors and others who are better equipped to help you than I. My suggestion is that you get her used to accepting help early on, I think it would make the subsequent years easier if she will. If assisted living is in the cards financially, the earlier the better and make sure you find a place that can handle dementia, some are better than others.

Good luck, I hope it works out for you.
 
Ted DuPuis said:
We've already gotten power of attorney and end of life plans figured out, so that's fortunate.

Next question: how does one arrange the evaluation and broach this topic? She will not be happy for me to bring it up. She also is on multiple meds for varying ailments, which could also be interfering.
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Just bring it up, she probably already senses something is wrong. Her doctor should be able to evaluate and refer her.
 
Ted DuPuis said:
We've already gotten power of attorney and end of life plans figured out, so that's fortunate.

Next question: how does one arrange the evaluation and broach this topic? She will not be happy for me to bring it up. She also is on multiple meds for varying ailments, which could also be interfering.
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Meds can be part of it, too. Our initial problem was a series of TIAs that caused what appeared to be dementia (and other problems). Meds and treatment were based on what those symptoms pointed to - with results that made it look like the dementia and other problems were getting worse, more meds, repeat. We finally were able to get a better set of tests from a different set of doctors, who found that the problems were not dementia after all and changed the treatment. I can't even properly describe how dramatic the change was for the better within just a matter of hours.

You'll have to work with her and her doctor to get her to agree. Depending on how stubborn she is - 1) she may notice the changes and be scared about it, then try to pretend it isn't really happening, and will refuse to believe it from anyone else. 2) she may not even realize there are behavioral changes so she'll fight you for trying to get her declared crazy. 3) She might notice the changes, is scared, and is just waiting for someone else to mention it.

I hope for the best.
 
Does your mother trust her doctor? If so, there are a variety of tests that can be done to rule out other causes of Dementia symptoms.

I hope it's not Alzheimer's or Dementia.
 
I agree about not waiting too long. Probably the best thing would be to have her evaluated by her primary care physician who might refer you to a neurologist who will do a bunch of cognitive tests. There are drugs that can possibly slow down the memory loss but they also have side effects so you and she would need to decide if she wants to take them. I decided against them for my mom but she is much older and much further along.
 
The biggest thing that needs to change is you. For all your life you were the one being told what to do. Now you must to do the telling. If you feel your mother is a danger to herself then it is time to bundle her onto a tube coming here and install her in a secure assisted living facility near your place of residence. You will become her advocate and make certain she is well cared for.

Unless there are other children or close family friend who you really trust, this is your only alternative.
 
Ted,

I watched what I thought was the onset of that in my mother after dad died. It was simply the fact she was living alone and had little to keep her occupied. She remarried, and all that changed and she was compos mentis till she passed.
 
I can still see my mom standing in the kitchen stomping her foot and insisting that she was not going to move into assisted living. We stuck to it and insisted that she move. It wasn't safe for her to stay there after my dad had died.

And there was the time when my sister took my dad's keys away.

Sometimes you just have to do what you have to do.

But it's not fun.
 
It can be a number of things but the treatment is typically the same. Aricept might get her some extension but if it's Alzheimers or Vascular Dementia, prepare for the worst. The only mitigating thing is that they rarely survive more than eight years after diagnosis. One thing I would suggest is to get ducks in a row while she is still lucid: advanced medical directives, medical and general powers of attorney, etc...
 
What you should do is take the airplane keys away from her, as based on your description of her behavior, she is prohibited from flying by 14 CFR 61.53.
 
Capt. Geoffrey Thorpe said:
I can still see my mom standing in the kitchen stomping her foot and insisting that she was not going to move into assisted living. We stuck to it and insisted that she move. It wasn't safe for her to stay there after my dad had died.

And there was the time when my sister took my dad's keys away.

Sometimes you just have to do what you have to do.

But it's not fun.
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No. No fun. And if you and I live long enough, our kids will have to do it to us, too. If they are the sort that will do it, we should be thankful. I know of plenty of offspring that just won't have anything to do with their folks once things start getting strange. They let some contractor do it. No visits to bring themselves or the grandkids. Not even at Christmas. It's sad.

Dan
 
Ask for referral to neurologist, drugs like Aricept and Namenda may help prevent progression of presenile dementia but do very little to reverse anything.

Depression in the elderly is under diagnosed frequently. Compounding issues may be nutrition if they live alone and hearing impairment.

If she lives in a populated area, search for geriatric psychiatrist. this would be good start.

I just had my father go through all this and thankfully we came out well.
Good Luck
 
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One of the things I have concluded in working with my older parents is that being proactive is very important. Better to move to a single story house a year too early than a day too late (after someone has taken a tumble down the stairs). There are a hundred other examples I could point out where acting early rather than late is the solution.

Ted, I'd suggest getting your mom tested and moving forward from there. Even if she tests well, make sure she is mentally active, and maybe see if she will wear one of the little emergency monitors. We eventually convinced Dad to do that, even though he "always" carried his cell. (Except for a couple of times when he fell and couldn't get up and spent hours on the ground because he was only going for a short walk and didn't need his cell...)
 
All the motivation you need to decide to talk to her about this is encapsulated in one thought, "If she hurts herself, how will I feel then?"

You know my dad passed way too young, but he and I had to do similar and make similar decisions for my grandfather. He was ultimately able to live in his own home until after 90, but we learned he had fallen and broken ribs two weeks before he passed.

It wasn't the cause of his passing, but it bothered both of us. We waited too long and believed him just a little too much.

I still do not like that we put him in a position where he had injured himself and was too proud to say anything about it.
 
X2 on the Neurologist, and possibly a Psychologist as well. Going through this with my mom (now 80) for the last few years. Her Husband died - she was depressed. Doctor prescribed some severe AD meds - caused problems. had to wean her off those, then realized her short term memory was gone, long term not much better. Got rid of the doctor - older folks really need someone that specializes in Geriatrics.

I went over one day a few years back and noticed the spare tire was on the front of the car. Looked at the old tire (in trunk) she had hit a curb hard enough to burst the tire. No idea how that happened. Year before it was the left side of the car - no mirror and both door handles sheared off (someone hit me). Psychologist took driving away (and boy did THAT start a riot - STILL dealing with that).

Talk to her several times a week, visit weekly - she rarely remembers much from the previous visit. Already looking into assisted living :(

It's not easy as others have said - but like was said above - at some point YOU become the parent.....
 
I have a former employee whose mother was having similar issues, she took charge of her mother's care and had a second look at all her medications. That was 3-4 years ago and her mom is doing fine at 88, sometimes doctors either prescribe to much or the combination of meds can cause issues. :mad2: Not saying that is the case here, but have her tested and have someone take a second look at ALL her meds.
Best of luck to you in a difficult situation.
 
N747JB said:
I have a former employee whose mother was having similar issues, she took charge of her mother's care and had a second look at all her medications. That was 3-4 years ago and her mom is doing fine at 88, sometimes doctors either prescribe to much or the combination of meds can cause issues. :mad2: Not saying that is the case here, but have her tested and have someone take a second look at ALL her meds.
Best of luck to you in a difficult situation.
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Does anyone know what meds are causing these problems??
 
I appreciate the helpful responses. Unfortunately, aging parents is something that most of us will have to deal with at some point.

While driving my mom to the airport to go home I broached the subject, and she was very receptive, saying that she'd noticed her brain wasn't working the same way it did 10 years ago, etc. She even said she'd been thinking about getting a Life Alert pendant, which I said I would gladly research and help her with. We'll also get her set up for some tests that I'll either go to with her or set up for a trusted friend to go with her. Long term I already have ideas that will provide the best balance of her maintaining her freedom and independence while being cared for, we'll just see how long before those have to get implemented.

When my grandmother was going through this, mom said how difficult it was for everyone and she wasn't going to be that way. Maybe she's following through. Either way, we'll see how it goes. I'd hoped I'd get to at least be over 30 before dealing with the start of this, but that's life.
 
You can get phones that have a pendant and auto dial to with a pre-programmed list of numbers (and finally 911) - no need to get ripped off by life-alert.

Many people end up being happier in senior facilities where there are people to talk to and things to do.
 
I just lost my mother to Alzheimer's last month.

One thing you will need to accept is that as the disease progresses, you will need to love the person that your mother is at each moment. She will not be the mother that she has been, but rather the mother who she is now.

I wish you the strength, patience and love you will need in the coming years.
 
Capt. Geoffrey Thorpe said:
You can get phones that have a pendant and auto dial to with a pre-programmed list of numbers (and finally 911) - no need to get ripped off by life-alert.
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Do you have a link? If it's easy, it might be worth the "rip off" fee. My mom is the least technologically competent person you will ever meet. Barely can use eMail. I have to book her plane tickets because she can't use Kayak.com

Many people end up being happier in senior facilities where there are people to talk to and things to do.
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True, but my mom likes her community that she's in. It will be much easier if she can stay in that community for as long as possible. We'll figure it out, the good part is that, if today is any indication, she's not going to be kicking and screaming about getting old and what goes with it. My grandmother was not that way.
 
Ted DuPuis said:
Do you have a link? If it's easy, it might be worth the "rip off" fee. My mom is the least technologically competent person you will ever meet. Barely can use eMail. I have to book her plane tickets because she can't use Kayak.com.
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It was something like one of these http://www.smithgear.com/gm-ampli600.html http://www.smithgear.com/cls-csc600er.html (My sister bought it, so I don't know the brand)

You will have to program it for her. But once programmed all she has to do is push the button.

Now, I will say, it can get to the point that she will not be able to remember to push a button, but that is long past the point that she would be living alone.
 
Jthamilton said:
Ask for referral to neurologist, drugs like Aricept and Namenda may help prevent progression of presenile dementia but do very little to reverse anything.
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A word of caution...My mother was put on Namenda with no real positive results, but it changed this sweet, always smiling woman into a mean and nasty person to deal with. We finally decided to stop using it and within a month, she was back to her old smiling self.

Some of these medications are just plain brutal in regards to side effects. Keep that in mind if you start any new meds.

And be prepared for a fight when you mention not driving anymore. That was by far the hardest part we had to deal with initially.
 
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Capt. Geoffrey Thorpe said:
Many people end up being happier in senior facilities where there are people to talk to and things to do.
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I'm hoping for exactly this! My mom currently lives with us and my wife has been the primary caregiver for 2 years in May. The problem is that my wife still has to work part time and that doesn't leave a lot of time for socializing. We've been looking at places for a couple of months and think we have found one that works. My wife took her there for a lunch to see how she fit in. Turns out, she sat an chatted with the others and seemed happy as could be.
 
Fortunately, my mom doesn't drive, so there's no fight there. :)

Thanks for the warning on the medication side effects. Her mood has been improving and she's also been trying to cut out meds because she didn't like side effects from them. So that's a step in the right direction.
 
Ted DuPuis said:
True, but my mom likes her community that she's in. It will be much easier if she can stay in that community for as long as possible. We'll figure it out, the good part is that, if today is any indication, she's not going to be kicking and screaming about getting old and what goes with it. My grandmother was not that way.
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If she is truly having cognitive issues then the secure facility into which she moves will become her community. It will go far Far FAR better for her if there is a family member in attendance.

She's not recovering or getting any better.
 
We are going through this with my grandmother right now, as well. It's not been a fun few months.
 
I lost one grandmother to Alzheimer's back in '98 and my other grandmother is going through it now. It is no fun at all - I wouldn't wish that on my worst enemy.

Good luck, Ted. I hope things turn out well for you.
 
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